Korelasi stadiumacute kidney injurydengankadar fosfat serum

Abstract

Hiperfosfatemia telah diketahui terjadi pada penyakit ginjal kronis (PGK). Terdapat hubungan linear antaraperburukan laju filtrasi glomerolus (LFG) dan peningkatan kadar fosfat serum pada PGK. Padaacute kidney injury(AKI) hubungan tersebut belum jelas. Beberapa penelitian pendahuluan melaporkan adanya peningkatan kadar fosfatserum pada pasien AKI. Tujuanpenelitian ini adalah mencari korelasi antara stadium AKI dan kadar fosfat serum.Dilakukanpenelitianpotonglintangdi RSUP Sanglah dari bulanJuni sampai Agustus2015 denganbesarsampel 53orang dipilihsecaraconsecutive sampling. Sampel yang memenuhikriteriadimintakankesediannyaberpartisipasidenganmenandatanganiinformed consent.Stadium AKI menggunakan kriteriadariKidneyDiseaseImprovingGlobalOutcome(KDIGO) tahun 2012, yaitu berdasarkan parameter kreatinin serum dan produksi urin.Kadar fosfat serumdiperiksa dengan metodemolibdate UVdi Laboratorium Prodia Denpasar. Hubungan stadiumAKI dan kadarfosfatserum dianalisis denganmenggunakan uji korelasi Spearman.Dari 53 pasienAKIterdiri dari 33(62,3%)orang pria,rerata umur 42(SB10,8)tahun.Berdasarkan kriteria KDIGO 2012 didapatkan 25 (47,2%) pasien AKI stadium 1, 12(22,6%) pasien AKI stadium 2 serta 16 (30,2%) pasien AKI stadium 3. Rerata kadar fosfat serum sebesar 4,7(SB2,10)mg/dl. Rerata kadar fosfat serum pada AKI tadium 1 sebesar 3,7(SB1,00)mg/dl, pada AKI stadium 2 sebesar4,6(SB1,20)mg/dl serta pada AKI stadium3 sebesar 6,5(SB2,70)mg/dl. Terdapat korelasi yang bermakna antarastadium AKIdankadarfosfat serum(r= 0,52,P<0,001).[MEDICINA.2016;50(3):17-22].

Hyperphosphatemia has been recognized in chronic kidney disease (CKD). There is linear correlation betweendecreased glomerular filtration rate (GFR) and increased serum phosphate level in CKD patients. This correlationisnot clear in acute kidney injury (AKI). Previous studies report that there is increasing of serum phosphate level inpatients with AKI.This study wasaimedto assess the correlation betweenseverity of AKIandserum phosphate level.Across-sectional study was performedat Sanglah Hospital from JunetoAugust 2015. Fiftythree patients wereselected with consecutive sampling technique. Eligiblesamples were requested for participation by signed informedconsent. Severity of AKI was defined byKidneyDiseaseImprovingGlobal Outcome(KDIGO) criteria2012, basedon serum creatinin and urine output. Serum phosphate level was measured usingmolibdate UVat Prodia laboratoryDenpasar.Correlationbetween severity of AKI and serumphosphate levelwas performed using spearman correlation.Thirty tree(62.3%) out of53samplesweremale, themean of age was42(SD10.8) years. Twenty five(47.2%)sampleswere categorized AKI stage I, 12samples(22.6%)stage 2  and16samples(30.2%)stage 3. Meanphosphatelevelwas4.7(SD2.10)mg/dl. Meanphophate levelwas3.7(SD1.00)mg/dlin AKI stage 1,4.6(SD1.20)mg/dlinAKI stage 2 and6.5(SD2.70)mg/dlin AKI stage 3. There wassignificantcorrelation between severity of AKI andserum phosphate levelhad been showed by this study (r = 0.52,P<0.001).[MEDICINA.2016;50(3):17-22].